Presentation
Right eye pain and proptosis.
Patient Data
A well-defined solid lesion in the right retrobulbar space near the orbital bony apex shows avid post-contrast enhancement. The lesion is significantly encasing and narrowing the right optic nerve.
The lesion demonstrates an intermediate signal on T1 and T2 weight images with homogeneous post-contrast enhancement.
There is resultant mild right-sided proptosis.
No significant extension to the cranial fossa is seen.
The globe shows normal size and normal ocular contents. The lens is intact.
The ocular walls are smooth, sharply defined, and of normal thickness.
The eye muscles are normally positioned and display normal width and course.
Features of chronic sinusitis are also present.
Case Discussion
The features are suggestive of an optic nerve sheath meningioma rather than a glioma.